Are These Pre-migraine (Prodrome) Symptoms?

Dizziness, tremor, hot flashes, fatigue, cold hands and feet, mental fogginess, nausea, increased pulse. I was excited to discover this cluster of symptoms and thought them to be warning signs, also called prodrome, that a migraine was coming on. The earlier a migraine is detected, the earlier it can be treated, thus increasing the likelihood it can be aborted altogether. At least a dozen times, I took a triptan when I recognized these symptoms coming on and avoided the migraine pain completely. I’d feel funky for an hour or two, then feel much better. Yay for triptans, or so I thought.

Grocery shopping one day, the symptoms hit and I didn’t think to take a triptan. The symptoms were so severe that my cart functioned as a walker. I felt awful when I got to the car and knew I should go home. But I really, really, really wanted to go to Goodwill.

I pushed through, risking worsening the migraine. I put on a hat, sunglasses and earplugs to get through the store and my decision-making abilities were severely curtailed. Still, an hour passed and on my way home I felt better than I did before I went to the thrift store. So much better that I spent the afternoon cooking and cleaning.

I began experimenting with not taking a triptan when the symptoms hit. They still lasted for an hour or two and then lifted. Exactly the same pattern as when I medicated for migraine.

Are these migraine symptoms at all or is something else causing these flushes of autonomic distress? My doctor speculates medication side effects and I’m going off my antidepressants to see if that’s the case. I have to wonder if they are part of some other disorder, maybe adrenal or autonomic. Any ideas?

23 Responses to Are These Pre-migraine (Prodrome) Symptoms?

I started getting these last year, and ended up spending a lot of days waiting for a headache that never hit. It seems to be worse in summer. Current speculation from my doctor is that it’s “silent migraine” and/or possibly something blood sugar related — we’re still cehcking things out.

Whatever it is, it’s awful! I have made many terrible decisions because of it (for example, The Incident involving a transit station, a 2L jug of milk, and deciding that I was allergic to something and needed to take two Benadryl. Spoiler: I wasn’t allergic to anything. I also don’t much remember getting home, but I must have somehow).

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Sometimes I hope it is migraine, sometimes I hope it is another illness that can be treated (unlike my migraines). The Incident sounds scary. I’m glad your doctor is working with you on finding the source.

My guess would be that, if it’s not a medication side effect, they *are* pre-migraine symptoms.

For me at least, pre-migraine signs don’t always lead to a full-blown migraine; in fact, I’ve come to think of those symptoms as part of a migraine, which may or may not include headache. Taking an abortive only sometimes helps and adds its own layer of side effects into the mix. I never had much luck with the older generation of triptans, though, so (as always!) YMMV.

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Thanks, that’s reassuring. I fall into the trap of wishing it were something other than migraine, something else that could be treated. Then I’m grateful that it is migraine and that my body is otherwise healthy.

Talked with my mom about it (she doesn’t get migraines like you and I do, but sees what they can do to us) and she’s convinced it’s a form of early menopause along with a migraine. Not sure if that helps.

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Fascinating idea. I have thought that it feels like what I expect a hot flash to feel like.

Kerry I experience exactly the same symptoms as you on a regular basis and also find if I see the worst of it through the attack will often dissipate. I stopped looking for complicated answers some time ago when I started understanding the way my nervous system was affecting my body, which was resulting in a myriad of reactions that altogether produced an anxiety state. I have suffered from severe migraine and related headaches for 40 years but it has taken me until recently to realise I had gradually become stuck in a cycle of chasing my own tail, so desperately looking for an answer or cure that I constantly exacerbated anxiety within my body, therefore continuousely producing the stress chemicals which promoted pain and all the other awful, often daily, anxiety symptoms – headache, palpitations, nausea, temperature swings,confussion and brain fog, muscle aches, trembling – the list is endless but without fail, if I am able to see through the episodes, they do pass. Like countless others, I have found huge support and comfort from the books by Dr. Claire Weekes – I luckily found these at a time when I had reached a point of nervous exhaustion and desperation trying to understand why I just couldn’t rid myself of the relentless head pain, despite trying everything from traditional drugs to natural remedies,elimination diets,meditation, relaxation – the list is endless and my mental health deteriorated due to failure after failure, leading to inevitable depression. I was so relieved to find a straight forward explanation, coupled with complete understanding of how I was feeling & I hope this may be of help to you also.

The symptoms you describe sound exactly like those I sometimes get (with the exception of nausea). I, too, am a frequent migraine sufferer. However, I have found that when I get the symptoms you outline, they are due to low blood sugar; I simply eat until I feel better, and the feelings pass in about 15 minutes. Note that I don’t have diabetes, and my blood sugar readings are always normal when tested. This advice is NOT for diabetics.

Now, at the same time, one of my migraine triggers is going too long without eating. Perhaps this is true for others. So presumably, if you or I got low blood sugar from not eating (including the symptoms you describe), we might get a migraine. But since triggers aren’t consistent, we may get a migraine one time but not another.

By the way, sometimes I get these low blood sugar symptoms even when I’ve eaten regularly scheduled meals. That could be true for you, too. Blood sugar can spike and dip according to what we eat.

By the way, as you described, it is possible to push through the low blood sugar moments. I’ve only had to do that a couple of times, but then the symptoms lasted 30 minutes to 2 hours, and I was incredibly weak, etc., until the episode passed.

You could try carrying a granola bar or glucose tablets with you, or just stop and get a big enough snack when this happens. I don’t know if this is your issue, but I wish you luck.

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Thanks for the suggestions, Karen. I’ll track when it happens and see if there’s appears to be a connection.

I don’t know what these symptoms may be, but I experience them pretty often.

Part of it could be blood sugar. As Karen recommended, I ALWAYS make sure to have some snacks (namely granola bars) in my purse. I have to eat a little bit every couple of hours, or I can definitely tell.

I can’t really push past the symptoms, though (at least not if it’s related to low blood sugar). I also get very weak, and sometimes it all happens very quickly. The symptoms normally just continue to intensify.

Triptans don’t work for me, so I’m not sure on that front. I hope that you find some relief. Blessings.

Your symptoms sound a lot like low blood sugar or dehydration, both of which can cause them. You didn’t say if you had light or sound sensitivity, although you put on sunglasses and earplugs. A few years ago, I was having weird episodes at random times. The symptoms included those you listed, except that I froze instead of having hot flashes. My doctor (GP) figured out that autonomic dysfunction, aka “dysautonomia,” was the culprit. Toprol reduced the racing heart episodes, but didn’t do quite enough. Then my doctor strongly recommended that I take Cymbalta because it acts on the autonomic nervous system. After about a month, I felt like me again. I’ve continued taking 60 mg. Cymbalta daily and haven’t had further problems. Please note that I’m 46 and have fibromyalgia, undifferentiated connective tissue disease, severe migraines, and Raynaud’s.

This happens to me quite frequently too! I started noticing it when I went on a daily medication for my chronic migraine. The meds helped with the pain but made me appreciate that the headache is only one part of what I like to think of as a full-blown neurological event.

This past year I’ve been studying at the Natural Gourmet where we learned about the expansive-contractive diet theory. Migraines fall on the contractive end of the spectrum–too much protein and salt–so it’s not unrelated to low blood sugar. When I’m experiencing these symptoms, I go for good bread with honey or fruit to settle things down.

Interesting. After 7 years of chronic migraines, I can’t say my experience has taught me a definite yes or no as to when my predome symptoms will develop into full blown migraine and when not. In either case, I take them as a signal to slow, get water, close my eyes and rest (if possible).

Often if I do, the headache passes. If I don’t rest soon enough, I risk going into full blown migraine.

The signs that are most serious for me are the light sensitivity, the inability to concentrate on what people are saying (and a subsequent lack of interest), a small one-sided pain on my head, and a bit of nausea, and a feeling my feet aren’t quite touching the ground. All of these are signs to stop everything immediately, and if i do, and do breathing exercises, or simply lie down with my cats, or lie very still and listen to the radio there is a chance that it will pass with no medication at all.

This is a long process of learning, and ultimately no way to guarantee anything, no right and wrong behaviors–as things change from day to day as to the necessity of medication…Migraines are so puzzling. And so is menopause and blood-sugar drops, etc

They could be anxiety related. I’ve had migraines most of my adult life, and only in recent years have I started to suffer from anxiety/panic related issues, and when that happens, I have the same symptoms you have. The anxiety may be tied into the other issues mentioned: low blood sugar, dehydration, and of course, the migraines. It’s all a bit of a vicious circle.
(And by the way, I’ve been a silent follower of your blog for over a year now. Really enjoy it!)

I agree with a lot of what others have already said. I think that you could be experiencing predome symptoms, but I also think that it could be hormonal. Women can go through peri-menopause years before going through menopause. When I’ve experienced the symptoms that you outlined I also find that I need to get to a cool spot. It tends to hit me when I’m in a store and I get overheated. So if I step outside to get some air it can help. I also immediately get some water in me and try to eat something as well. The combo of all these things usually helps. So regardless of whether they are predome or something else, just keep doing what you do to minimize the symptoms and hopefully you’ll be able to avoid a migraine…and be able to skip the triptans.

Have you or your doctors considered POTS? It is common with migraines. My 14 yr old son has it as well as migraines. There are tests for this condition, which is treated by a cardiologist, and medications that can help. Does your heartrate increase more than 30 beats or over 120 upon standing, or after standing for awhile? It is a form of Orthostatic Intolerance. Also check blood pressure lying down, then sitting, then standing.

Does anyone suffer with “Bradycardia” as a prodrome symptom? (low heart rate like in the 40s and 50s) along with the dizzy, floaty, walking on a cloud, marshmellowy, “off”, lightheaded, off balance, blurred vision, stiff neck, paresthesia in arms/shoulder and stuffy, nasal, post nasal drip-ish feeling??
Also finding that autonomic dysfunction (as in POTS like Karen said above) is also very common with migraine. But VERY interested in the LOW heart rate issue??

I had these exact symptoms, and it would escalate into a brutal migraine. I was determined to find the answer! I googled until i was nearly blind! I kept coming up with thyroid websites, but my doctor said my thyroid was low normal…so i searched on….Finding that 99% of thyroid issues are missed by a standard TSH test!!! I demanded that my thyroid be checked again in a 4 panel test for tsh, t3 and t4, BINGO!! Severe hypothyroidism, when the other test said I was fine! as long as I stay on my meds, I have none of these “spells”! I still have migraines and food allergies, but i can function now! I hope this helps!

Sounds like silent migraines to me. I usually get silent migraines as my pain is often only a 0 or 1 out of 4. However usually my typically extreme sense fatigue and photophobia more than makes up for the lack of pain. Occasionally it will come with significant cognitive impairment, balance issues, nausea, aphasia. My migraine hangovers can last a few days too … but typically postdrome is pretty mild.

The problem is if you silent migraine goes unnoticed you may not take your abortive until the damn migraine is entrenched and it’s harder to dislodge. For me if it’s too late I have to crash for two hours with the meds to do anything. If I do catch it early enough the Maxslt RPD will do the job in moments.

I have very similar symptoms. I was diagnosed with basilar migraines. Because of a slightly increased risk of stroke with basilar migraines, my neurologist recommended Cambia (diclofenac) instead of triptans (which I was sad to stop using). Even though the Cambia is just an NSAID, it actually works the majority of the time. I’m now just wondering what to do when I get pregnant as triptans and NSAIDs are both not recommended in pregnancy.

I know this sounds awful, but I’m so glad that other people understand what I deal with during my migraines. My neurolgist was able to tie a bunch of random symptoms (joint pain/swelling, full body skin flushing, always thirsty/need to go, bloodshot eyes, and more) that I gradually acquired over the course of a year or so and say ‘Best guess, migraines.’ I take Verapamil for my heart and hbp, and got luck, because I went from never ending symptoms, to migraines once every couple of months. I REALLY suffer during the prodrome, but my body is good enough to do specific, weird things if I’m actually looking at a migraine. I have latent hyperopia, basically when my body is unable to MAKE my eyes focus, I can’t, rapidly. Like, reading a book one second, flip the page and all I can see are grey lines. If I HAVE to put on my reading glasses to see, I’m having a migraine.